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ESET and the Ponemon Institute have announced results of The State of Cybersecurity in Healthcare Organizations in 2016.

According to the study, healthcare organizations average about one cyber attack per month with 48% of respondents said their organizations have experienced an incident involving the loss or exposure of patient information during the last 12 months. Yet despite these incidents, only half indicated their organization has an incident response plan in place.

The concurrence of technology advances and delays in technology updates creates a perfect storm for healthcare IT security,” said Stephen Cobb, senior security researcher at ESET. “The healthcare sector needs to organize incident response processes at the same level as cyber criminals to properly protect health data relative to current and future threat levels. A good start would be for all organizations to put incident response processes in place, including comprehensive backup and disaster recovery mechanisms. Beyond that, there is clearly a need for effective DDoS and malware protection, strong authentication, encryption and patch management

Key findings of the survey:

78% of respondents, the most common security incident is the exploitation of existing software vulnerabilities greater than three months old.

63% said the primary consequences of APTs and zero-day attacks were IT downtime

46% of respondents experienced an inability to provide services which create serious risks for patient treatment.

Hackers are most interested in stealing patient information

The most attractive and lucrative target for unauthorized access and abuse can be found in patients’ medical records, according to 81% of respondents.

Healthcare organizations worry most about system failures

79% of respondents said that system failures are one of the top three threats facing their organizations

52% of respondents said legacy systems and new technologies to support cloud and mobile implementations, big data and the Internet of Things increase security vulnerabilities for patient information

46% of respondents also expressed concern about the impact of employee negligence

45% cited the ineffectiveness of HIPAA mandated business associate agreements designed to ensure patient information security

DDoS attacks have cost organizations on average $1.32 million in the past 12 months

37% of respondents say their organization experienced a DDoS attack that caused a disruption to operations and/or system downtime about every four months. These attacks cost an average of $1.32 million each, including lost productivity, reputation loss and brand damage.

Healthcare organizations need a healthy dose of investment in technologies

On average, healthcare organizations represented in this research spend $23 million annually on IT

12% on average is allocated to information security

Since an average of $1.3 million is spent annually for DDoS attacks alone, a business case can be made to increase technology investments to reduce the frequency of successful attacks

Based on our field research, healthcare organizations are struggling to deal with a variety of threats, but they are pessimistic about their ability to mitigate risks, vulnerabilities and attacks,” said Larry Ponemon, chairman and founder of The Ponemon Institute. “As evidenced by the headline-grabbing data breaches over the past few years at large insurers and healthcare systems, hackers are finding the most lucrative information in patient medical records. As a result, there is more pressure than ever for healthcare organizations to refine their cybersecurity strategies

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Skyhigh Networks released its new “Cloud Adoption & Risk in the Government Report.” The Q1 2015 report reveals that shadow IT is prevalent in government agencies.

The average public sector organization uses 742 cloud services, which is about 10-20 times more than IT departments expect. Despite the security initiatives in place, such as FedRAMP, FISMA, and FITARA, many government employees are unaware of agency rules and regulations or simply ignore them and use cloud services that drive collaboration and productivity.

As agencies grapple with how to manage shadow IT and securely enable sanctioned IT, they need visibility into the real usage and risk of cloud services as well as the ability to detect threats and seamlessly enforce security, compliance, and governance policies,” said Rajiv Gupta, CEO of Skyhigh Networks. “Skyhigh manages shadow IT and securely enables sanctioned IT, allowing public sector organizations to use hundreds of cloud services while providing robust data protection services, thereby meeting data privacy requirements and conforming to regulations

Despite clear benefits of cloud services Federal agencies are slow to migrate to the cloud due to security concerns. As a result, employees adopt cloud services on their own, creating shadow IT. Under FITARA, Federal CIOs must oversee sanctioned cloud services as well as shadow IT. This new requirement underscores the uncertainty about how employees are using cloud services within their agencies.

Understanding Shadow IT
The average public sector organization now uses 742 cloud services, which is about 10-20 times more than IT departments report. What agencies don’t know can hurt them. When asked about insider threats, just 7% of IT and IT security professionals at public sector organizations indicated their agency had experienced an insider threat. However, looking at actual anomaly data, Skyhigh Networks found that 82% of public sector organizations had behavior indicative of an insider threat.

Agencies cannot rely on the security controls offered by cloud providers alone. Analyzing more than 12,000 cloud services across more than 50 attributes of enterprise readiness developed with the Cloud Security Alliance, the report found that just 9.3% achieved the highest CloudTrust Rating of Enterprise Ready. Only 10% of cloud services encrypt data stored at rest, 15% support multi-factor authentication, and 6% have ISO 27001 certification. Skyhigh Networks helps Federal agencies address these security gaps and gain control over shadow IT by providing unparalleled visibility, comprehensive risk assessment, advanced usage and threat analytics, and seamless policy enforcement.

Password Insecurity
Compromised credentials can also mean disaster for Federal agencies. According to a study by Joseph Bonneau at the University of Cambridge, 31% of passwords are used in multiple places. This means that for 31% of compromised credentials, attackers can potentially gain access not only to all the data in that cloud service, but all the data in other cloud services as well. The average public sector employee uses more than 16 cloud services, and 37% of users upload sensitive data to cloud file sharing services. As a result, the impact of one compromised account can be immense.

The Skyhigh “Cloud Adoption & Risk in the Government Report” reveals that 96.2% of public sector organizations have users with compromised credentials and, at the average agency, 6.4% of employees have at least one compromised credential.

Cloud Services in the Public Sector
Most cloud services deployed in the public sector are collaboration tools. The average organization uses 120 distinct collaboration services, such as Microsoft Office 365, Gmail, and Cisco Webex. Other top cloud services are software development services, file sharing services, and content sharing services. The average employee uses 16.8 cloud services including 2.9 content sharing services, 2.8 collaboration service, 2.6 social media services, and 1.3 file sharing services. Shockingly, the average public sector employee’s online movements are monitored by 2.7 advertising and web analytics tracking services, the same services used by cyber criminals to inform watering hole attacks.

The report also reveals the top cloud services used in the public sector.

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The Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data reveals that the majority of healthcare organizations represented in this study have experienced multiple security incidents and nearly all have faced a data breach. Despite the universal risk for data breach, the study found that many organizations lack the funds and resources to protect patient data and are unprepared to meet the changing cyber threat environment.

The 2015 study was expanded beyond healthcare organizations to include Business Associates.

Represented in this study are 90 covered entities (hereafter referred to as healthcare organizations) and 88 business associates (hereafter may be referred to as either business associates or BAs). A BA is a person or entity that performs services for a covered entity that involves the use or disclosure of protected health information (PHI), according to the U.S.

Department of Health & Human Services. The inclusion of BAs provides a broader perspective of the healthcare industry as a whole and demonstrates the impact third parties have on the privacy and security of patient data. Respondents were surveyed about their privacy and security practices and experiences with data breaches, as well as their experiences with both electronic and paper security incidents.

Data breaches in healthcare continue to put patient data at risk and are costly. Based on the results of this study, they estimate that data breaches could be costing the industry $6 billion.

90% of healthcare organizations represented in this study had a data breach

40% had more than five data breaches over the past two years

According to the findings of this research, the average cost of a data breach for healthcare organizations is estimated to be more than $2.1 million. No healthcare organization, regardless of size, is immune from data breach. The average cost of a data breach to BAs represented in this research is more than $1 million. Despite this, half of all organizations have little or no confidence in their ability to detect all patient data loss or theft.

For the first time, criminal attacks are the number one cause of data breaches in healthcare. Criminal attacks on healthcare organizations are up 125% compared to five years ago. In fact, 45% of healthcare organizations say the root cause of the data breach was a criminal attack and 12 % say it was due to a malicious insider. In the case of BAs, 39% say a criminal attacker caused the breach and 10% say it was due to a malicious insider.

The percentage of criminal-based security incidents is even higher; for instance, web-borne malware attacks caused security incidents for 78% of healthcare organizations and 82% for BAs. Despite the changing threat environment, however, organizations are not changing their behaviour, only 40% of healthcare organizations and 35% of BAs are concerned about cyber attackers.

Security incidents are part of everyday business. 65% of healthcare organizations and 87% of BAs report their organizations experienced electronic information-based security incidents over the past two years.

However, many organizations do not have the budget and resources to protect both electronic and paper-based patient information. For instance, 56 % of healthcare organizations and 59% of BAs don’t believe their incident response process has adequate funding and resources. In addition, the majority of both types of organizations fail to perform a risk assessment for security incidents, despite the federal mandate to do so.

Even though medical identity theft nearly doubled in five years, from 1.4 million adult victims to over 2.3 million in 2014, the harms to individuals affected by a breach are not being addressed. Many medical identity theft victims report they have spent an average of $13,500 to restore their credit, reimburse their healthcare provider for fraudulent claims and correct inaccuracies in their health records.

Nearly two-thirds of both healthcare organizations and BAs do not offer any protection services for patients whose information has been breached.

Since 2010, this study has tracked privacy and security trends of patient data at healthcare organizations. Although the annual economic impact of a data breach has remained consistent over the past five years, the most-often reported root cause of a data breach is shifting from lost or stolen computing devices to criminal attacks. At the same time, employee negligence remains a top concern when it comes to exposing patient data. Even though organizations are slowly increasing their budgets and resources to protect healthcare data, they continue to believe not enough investment is being made to meet the changing threat landscape.

Key Findings

In this section, they provide a deeper analysis of the findings. They have organized this report according to the two following topics:

Privacy and security of patient data in healthcare organizations and business associates

Five-year trends in privacy and security practices in healthcare organizations

To respond quickly to data breaches, organizations need to invest more in technologies.

58 % of healthcare organizations agree that policies and procedures are in place to effectively prevent or quickly detect unauthorized patient data access, loss or theft.

49% agree they have sufficient technologies

33% agree they have sufficient resources to prevent or quickly detect a data breach.

53% of organizations have personnel with the necessary technical expertise to be able to identify and resolve data breaches involving the unauthorized access, loss or theft of patient data.

Background

Covered entities are defined in the HIPAA rules as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.

A security incident is defined as a violation of an organization’s security or privacy policies involving protected information such as social security numbers or confidential medical information. A data breach is an incident that meets specific legal definitions per applicable breach law(s). Data breaches require notification to the victims and may result in regulatory investigation, corrective actions, and fines.

This is based on multiplying $1,067,400 (50% of the average two year cost of a data breach experienced by the 90 healthcare organizations in this research) x 5,686 (the total number of registered US hospitals per the AHA).

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CloudLock have produced an interesting report on how the use of the cloud and apps has extending the perimeter of most organisations.

CloudLock Executive Summary

The adoption of public cloud applications continues to accelerate for both organizations and individuals at an exponential rate, evidenced across the massive growth in the volume of accounts, files, collaboration, and connected third-party cloud applications.

The rapid surge of accounts, files, and applications presents increased risk in the form of an extended data perimeter. The adoption of cloud applications has significantly increased the threat surface for cyber attacks. Faced with this massive growth and the elevated risk, security professionals are looking to enable their organizations to embrace and leverage the benefits of cloud technologies while remaining secure and compliant.

Sensitive data is moving to the cloud, beyond the protection of your perimeter controls. As this occurs ,the amount of data, and, most importantly, the amount of sensitive or ‘toxic’ data the enterprise stores in these Software-as-a-Service (SaaS) and Infrastructure-as-a-Service (laaS) platforms is increasing by the day – and regardless of its locations, S&R pros still need to protect it effectively.” Forrester Research (2015, March) Market Overview: Cloud Data Protection Solutions

Other findings

100,000 files per organization that represent risk. Number of files per organization stored in public cloud applications that violate corporate data security policy, amplifying the danger of exposing sensitive information.

4x increase in the number of third-party applications enabled per organization, from 130 to 475. The total number of unique third-party cloud apps ballooned to 77,000, amounting to 2.5 million installs

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The spate of recent data breaches at big-name companies such as JPMorgan Chase, Home Depot, and Target raises questions about the effectiveness of the private sector’s information security.

According to FBI Director James Comey

There are two kinds of big companies in the United States. There are those who’ve been hacked…and those who don’t know they’ve been hacked

A recent survey by the Ponemon Institute showed the average cost of cyber crime for U.S. retail stores more than doubled from 2013 to an annual average of $8.6 million per company in 2014. The annual average cost per company of successful cyber attacks increased to $20.8 million in financial services, $14.5 million in the technology sector, and $12.7 million in communications industries.

This paper lists known cyber attacks on private U.S. companies since the beginning of 2014. (A companion paper discussed cyber breaches in the federal government.) By its very nature, a list of this sort is incomplete. The scope of many attacks is not fully known. For example, in July, the U.S. Computer Emergency Readiness Team issued an advisory that more than 1,000 U.S. businesses have been affected by the Backoff malware, which targets point-of-sale (POS) systems used by most retail industries. These attacks targeted administrative and customer data and, in some cases, financial data.

This list includes only cyber attacks that have been made known to the public. Most companies encounter multiple cyber attacks every day, many unknown to the public and many unknown to the companies themselves.

The data breaches below are listed chronologically by month of public notice.

January

Target (retail). In January, Target announced an additional 70 million individuals’ contact information was taken during the December 2013 breach, in which 40 million customer’s credit and debit card information was stolen.

Neiman Marcus (retail). Between July and October 2013, the credit card information of 350,000 individuals was stolen, and more than 9,000 of the credit cards have been used fraudulently since the attack. Sophisticated code written by the hackers allowed them to move through company computers, undetected by company employees for months.

Michaels (retail). Between May 2013 and January 2014, the payment cards of 2.6 million Michaels customers were affected. Attackers targeted the Michaels POS system to gain access to their systems.

Yahoo! Mail (communications). The e-mail service for 273 million users was reportedly hacked in January, although the specific number of accounts affected was not released.

April

Aaron Brothers (retail). The credit and debit card information for roughly 400,000 customers of Aaron Brothers, a subsidiary of Michaels, was compromised by the same POS system malware.

AT&T (communications). For two weeks AT&T was hacked from the inside by personnel who accessed user information, including social security information.

May

eBay (retail). Cyber attacks in late February and early March led to the compromise of eBay employee log-ins, allowing access to the contact and log-in information for 233 million eBay customers. eBay issued a statement asking all users to change their passwords.

Five Chinese hackers indicted. Five Chinese nationals were indicted for computer hacking and economic espionage of U.S. companies between 2006 and 2014. The targeted companies included Westinghouse Electric (energy and utilities), U.S. subsidiaries of SolarWorld AG (industrial), United States Steel (industrial), Allegheny Technologies (technology), United Steel Workers Union (services), and Alcoa (industrial).

Unnamed public works (energy and utilities). According to the Department of Homeland Security, an unnamed public utility’s control systems were accessed by hackers through a brute-force attack on employee’s log-in passwords.

June

Evernote (technology). In the same week as the Feedly cyber attack, Evernote and its 100 million users faced a similar denial-of-service attack.

P.F. Chang’s China Bistro (restaurant). Between September 2013 and June 2014, credit and debit card information from 33 P.F. Chang’s restaurants was compromised and reportedly sold online.

August

U.S. Investigations Services (services). U.S. Investigations Services, a subcontractor for federal employee background checks, suffered a data breach in August, which led to the theft of employee personnel information. Although no specific origin of attack was reported, the company believes the attack was state-sponsored.

Community Health Services (health care). At Community Health Service (CHS), the personal data for 4.5 million patients were compromised between April and June. CHS warns that any patient who visited any of its 206 hospital locations over the past five years may have had his or her data compromised. The sophisticated malware used in the attack reportedly originated in China. The FBI warns that other health care firms may also have been attacked.

UPS (services). Between January and August, customer information from more than 60 UPS stores was compromised, including financial data, reportedly as a result of the Backoff malware attacks.

Defense Industries (defense). Su Bin, a 49-year-old Chinese national, was indicted for hacking defense companies such as Boeing. Between 2009 and 2013, Bin reportedly worked with two other hackers in an attempt to steal manufacturing plans for defense programs, such as the F-35 and F-22 fighter jets.

September

Home Depot (retail). Cyber criminals reportedly used malware to compromise the credit card information for roughly 56 million shoppers in Home Depot’s 2,000 U.S. and Canadian outlets.

Google (communications). Reportedly, 5 million Gmail usernames and passwords were compromised. About 100,000 were released on a Russian forum site.

Apple iCloud (technology). Hackers reportedly used passwords hacked with brute-force tactics and third-party applications to access Apple user’s online data storage, leading to the subsequent posting of celebrities’ private photos online. It is uncertain whether users or Apple were at fault for the attack.

Goodwill Industries International (retail). Between February 2013 and August 2014, information for roughly 868,000 credit and debit cards was reportedly stolen from 330 Goodwill stores. Malware infected the chain store through infected third-party vendors.

SuperValu (retail). SuperValu was attacked between June and July, and suffered another malware attack between late August and September. The first theft included customer and payment card information from some of its Cub Foods, Farm Fresh, Shop ‘n Save, and Shoppers stores. The second attack reportedly involved only payment card data.

Bartell Hotels (hotel). The information for up to 55,000 customers was reportedly stolen between February and May.

U.S. Transportation Command contractors (transportation). A Senate report revealed that networks of the U.S. Transportation Command’s contractors were successfully breached 50 times between June 2012 and May 2013. At least 20 of the breaches were attributed to attacks originating from China.

October

J.P. Morgan Chase (financial). An attack in June was not noticed until August. The contact information for 76 million households and 7 million small businesses was compromised. The hackers may have originated in Russia and may have ties to the Russian government.

Dairy Queen International (restaurant). Credit and debit card information from 395 Dairy Queen and Orange Julius stores was compromised by the Backoff malware.

Snapsave (communications). Reportedly, the photos of 200,000 users were hacked from Snapsave, a third-party app for saving photos from Snapchat, an instant photo-sharing app.

Securing Information

As cyber attacks on retail, technology, and industrial companies increase so does the importance of cybersecurity. From brute-force attacks on networks to malware compromising credit card information to disgruntled employees sabotaging their companies’ networks from the inside, companies and their customers need to secure their data. To improve the private sector’s ability to defend itself, Congress should:

Create a safe legal environment for sharing information. As the leaders of technological growth, private companies are in most ways at the forefront of cyber security. Much like government agencies, companies must share information that concerns cyber threats and attack among themselves and with appropriate private-public organizations. Congress needs to create a safe environment in which companies can voluntarily share information without fear of legal or regulatory backlash.

Work with international partners. As with the Backoff malware attacks, attacks can affect hundreds if not thousands of individual networks. These infected networks can then infect companies outside the U.S. and vice versa. U.S. and foreign companies and governments need to work together to increase overall cybersecurity and to enable action against individual cyber criminals and known state-sponsored cyber aggressors.

Encourage cyber insurance. Successful cyber attacks are inevitable because no security is perfect. With the number of breaches growing daily, a cybersecurity insurance market is developing to mitigate the cost of breaches. Congress and the Administration should encourage the proper allocation of liability and the establishment of a cyber insurance system to mitigate faulty cyber practices and human error.

Conclusion

The recent increases in the rate and the severity of cyber attacks on U.S. companies indicate a clear threat to businesses and customers. As businesses come to terms with the increasing threat of hackers, instituting the right policies is critical to harnessing the power of the private sector. In a cyber environment with ever-changing risks and threats, the government needs to do more to support the private sector in establishing sound cybersecurity while not creating regulations that hinder businesses more than help them.

— Riley Walters is a Research Assistant in the Asian Studies Center, of the Kathryn and Shelby Cullom Davis Institute for National Security and Foreign Policy, at The Heritage Foundation.

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The Information Commissioner’s Office report on how organisations providing secondary health care are complying with the Data Protection Act and highlights areas that need improvement.

The report summarises the results of 19 audits, mostly against NHS Trusts.

The audits looked at how personal data is handled by the organisation, and fit alongside NHS information governance guidelines. The organisations voluntarily agreed to work with the ICO to identify good practice and, where necessary, improve procedures relating to the handling of personal data.

The Audits found:

All the organisations had data protection policies and procedures in place, though compliance with the policies wasn’t always effectively monitored, for instance through spot checks.

All the organisations had a system in place to track health records, though some did not conduct audits for missing files. The physical security of records also varied, with concern raised particularly around unlocked trollies used for moving files.

There was also a lack of simple password controls, notably forcing regular password changes.

Some organisations had little in the way of fire or flood protection in place for paper records.

All organisations had appropriate information governance related risk registers and risk assessments that were regularly reviewed.

Concern was raised around the use of fax machines for sending personal information, given the human error associated with using a fax machine.

Before three of the audits, staff were surveyed about their awareness of data protection policies

88% of staff had read and understood the policy in place within their organisation

94% had completed data protection training within the previous year

Claire Chadwick, ICO Team Manager in the Good Practice team, said:

Information about a person’s health tends to be one of the most sensitive types of personal data, and it is clear it must be properly handled.

“Our experiences in these audits suggested that tended to be the case. Only one of the audits suggested a substantial risk of non-compliance with the law, while more than half gave reasonable assurance the law was being complied with.

“By paying attention to this report, more organisations in this sector can ensure they are handling personal information properly. This report is an opportunity to review and improve practices and procedures based on our experiences

The audits followed a letter from the Information Commissioner and the Chief Executive of the NHS Sir David Nicholson to chief executives and finance directors within the NHS.

The ICO reported on the 12th March 2013 that Marcia Phillips was prosecuted under section 55 of the Data Protection Act and fined £750 and ordered to pay a £15 victim surcharge and £400 prosecution costs.

Ms Phillips was found to have accessed the information on 15 separate occasions over a 16-month period while working as a receptionist at the Bath Lodge Practice. The breach became apparent after Phillips left her job and sent a text message to her ex-husband’s partner referring to highly sensitive medical information taken from her medical record.

Deputy Commissioner and Director of Data Protection, David Smith, said:

This case clearly shows the distress that can be caused when an individual uses a position of responsibility to illegally access sensitive personal information. Ms Phillips knew she was breaking the law, but continued to do so in order to cause harm to her ex-husband’s new wife.

“The nature of her job meant that she will have been in no doubt as to the importance of patient confidentiality. Despite this she repeatedly accessed the victim’s file without a valid reason

Unlawfully obtaining or accessing personal data is a criminal offence under section 55 of the Data Protection Act 1998. The offence is punishable by way of a fine of up to £5,000 in a Magistrates Court or an unlimited fine in a Crown Court. The ICO continues to call for more effective deterrent sentences, including the threat of prison, to be available to the courts to stop the unlawful use of personal information.

David Smith added:

We continue to urge the Government to press ahead with the introduction of tougher penalties to enforce the Data Protection Act. Without these unscrupulous individuals will continue to break the law. Action to replace the section 55 ‘fine only’ regime with an effective deterrent is long overdue. This change is not directed at the media and should not be held while Lord Justice Leveson‘s recommendations on data protection and the media are considered

The survey found many areas of improvement and highlighted them in the infographic below:

Key highlights from the HIMSS study include:

Only 38% of the respondents encrypt mobile devices, such as smartphones and tablets, which is worrisome considering their rising use. In fact, there are currently 1.1 billion global smartphone subscribers, representing a 42% year over year growth rate. In addition, there’s been a 29% increase in tablet or e-reader users since 2009.

Only 43% of respondents test their data response plans, meaning they don’t know whether their plans work. Organisations should review their response plans regularly and conduct practice runs at least once per year. It’s also a good idea to update the contact list of your response team quarterly and redistribute it.

64% of this year’s respondents encrypt emails, compared to 55% in 2008.

Two-thirds conduct a risk analysis at least once per year, compared to 54% in 2008

Nearly 25% of the respondents sustained a data breach in the past year alone

the high number of breaches has caused 21 million American patients to have their healthcare records exposed to date

90% of the respondents (Hospitals) in a recent study indicating that they conduct formal risk analyses.

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Every privacy professional knows that risk analysis is a foundation for successful information privacy and security, just as flossing your teeth is a foundation for good oral health. If you’re in healthcare, you also know that risk analysis is one of the five core Office for Civil Rights (OCR) “culture of compliance” requirements, and a prerequisite to receiving “meaningful use” dollars for implementing electronic health records (EHR). But what you may not know, according to nationally recognized information security expert and former HIPAA Compliance Officer Chris Apgar, is that compliance is not the biggest reason for conducting ongoing risk analysis. The biggest reason is that it can save your business.

OCR audits are proceeding, and failure to conduct risk analysis can result in a finding of “willful neglect” with penalties up to $50,000 per incident and up to $1.5 million per calendar year for the same type of violation (and any such finding will typically involve multiple types of violations). That risk, alone, justifies the cost of conducting risk analysis. A thorough risk analysis also provides a strategic roadmap for security spending, but Apgar says that even now, when he speaks to groups about medical data privacy, only about 1/3 of all healthcare organizations that are not seeking “meaningful use” dollars indicate that they’ve conducted risk analysis, and he points out that this is dangerous because by deferring the analysis, they may fail to identify other risks such as lawsuits, civil penalties, and loss of reputation that could damage or destroy their business.

Here are three other things Chris Apgar says you need to know risk analysis:

Confidentiality is not enough. The three pillars of security are confidentiality, availability, and integrity, and risk analysis needs to account for all of these. Yes, you want to prevent data breach, but that’s not enough. For example, what happens if a patient is in critical care, systems go down, and doctors lose access to critical information they need to make medical decisions? Data corruption can be even more serious because if doctors unknowingly make bad healthcare decisions based on corrupt information, lives can be lost.

Technical security is not enough. Apgar says that, too often, when an organization looks at risks, they look only on the digital side, but PHI risks extend far beyond technical infrastructure. You need to look at every place where PHI lives, in any form, and everyone who touches it. For example, encryption can mitigate risk in case of a security related incident involving electronic records, but you can’t encrypt paper. So if paper records are lost, by definition, that’s a security incident and potentially a reportable breach. People and process risks also have to be assessed as part of the security plan. One privacy officer that Apgar worked with pointed out that he and other compliance professionals in the organization had to be considered as organizational assets and as liabilities, because at that time, they were the only ones who knew how to respond in case of an incident, and if they were unavailable, the organization would be at risk.

There’s more than one way to become a covered entity. A new Texas healthcare privacy law goes into effect this month. Apgar says that, in addition to non-compliance penalties over and above the federal, it has a broader definition of covered entities. Under the Texas law, if an organization handles any sort of electronic healthcare information, no matter its role in the healthcare system, it is covered by the new privacy requirements and considered a covered entity. So, for example, a small dental practice that transmits HIPAA covered transactions in Texas is now a covered entity under Texas law. In addition, business associates and subcontractors could now face non-compliance fines from both OCR and state of Texas. Other states, including California and Massachusetts, also have high levels of regulation around healthcare information. A thorough and ongoing risk analysis program is necessary to keep organizations of all sizes abreast of new risks and requirements at state and federal levels.

Apgar has a number of practical recommendations for conducting risk analysis.

Successful risk analysis begins with a thorough inventory that accounts for all assets: digital, physical, and human. He points out that you need that inventory, anyway, to create a disaster recovery plan, and that keeping that inventory current makes the initial risk analysis and updates relatively simple because you have a baseline to work from.

Think of things inside the organization that can hurt you. “Threats” are unpredictable outside factors such as natural disasters and hackers that require response plans, but there are “vulnerabilities” that you can address to head off trouble. For example, you can help preventing network attacks by putting in place a process to ensure security patches are always kept up to date.

The risk analysis needs to rate risks both in terms of likelihood and in terms of potential harm or impact. For example, tsunamis are unlikely in Oklahoma so they don’t need to be part of an Omaha hospital’s disaster recovery plan, and unauthorized access to one patient record showing on a computer screen is likely to cause far less damage than a stolen computer full of patient records in lab’s business office. Once you’ve made a reasonable assessment of the likelihood and potential impact, it will become clear how best to spend your security budget and resources.

Don’t stop with the risk analysis. Meaningful use requires risk analysis, documentation, a mitigation plan, and implementation of a risk management program. Whether or not your organization is seeking meaningful use dollars, knowing about a risk offers little protection if you don’t act on the knowledge and implement steps to manage risk throughout the year.

If you bring in experts to conduct a risk analysis or to help your staff conduct one, look for someone who has done this before in healthcare and who has a track record with your type of healthcare business. Make sure their products and services address more than just technical security, and check references, of course, but also ask colleagues about their reputation. Word travels fast in the healthcare industry, and word on the street may tell you things that you won’t find out in a reference check.

Chris Apgar says the most critical thing to realize about risk analysis is that it stretches beyond what the regulations require. “There are so many other risks: the risk of being sued, of losing your practice, of causing harm to your patients. Yes, doing risk analysis costs time and money, but not doing it is a good way to lose more money or lose your business.”

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Dimension Data announced the results of its Network Barometer Report for 2012. The findings of the report have been taken from 294 “Technology Lifecycle Management” (TLM) assessments of enterprise organizations.

TLM review a networks’ readiness to support business by reviewing network device across four distinct areas:-

Security vulnerabilities

Configuration variance from best practice

IOS Version Management

End-of-Life status

The report has a concentrates mainly on Cisco products as they form the largest vendor in the Dimension Data installed support base.

Key finding of the report

75% of network devices are carrying at least one known security vulnerability, in line with the 73% in 2011.

A single vulnerability was responsible for this high PSIRT penetration. PSIRT 10944, identified by Cisco in September 2009, was found in 47% of all the devices analysed during 2011 (A PSIRT is a software vulnerability that has been identified by Cisco’s Product Security Incident Response Team)

While the number of configuration errors per device increased from 29 to 43, security related configuration errors such as AAA Authentication continue to dominate

The percentage of devices that entered the obsolescence phase increased from 38% to 45%

Of those devices, the percentage that were End-of-Sale (EoS) jumped from 4.2% in 2011 to 70% in 2012. The percentage of devices that were either EoSW maintenance EoCR dropped a similarly dramatic amount from 86.2% to 20.8%.

A third of all Wireless access points discovered during the calendar year 2011 were 802.11n-capable. This is nearly triple the 12% 802n penetration from last year. This adoption will also drive refresh in the underlying routing and switching infrastructure

After peaking at 64 new PSIRTS in 2007, the announcements had tapered off in the 45 to 50 range for the past three years, before spiking again to 60 in in 2011

On average, 40% of all devices have been past EoS for the past four years. That said, there have been small year–on-year increases over the past three years – 3% from 2010 to 2011 and 7% from 2011 to 2012.

The report states

“While the overall percentage of devices carrying at least one known security vulnerability stayed constant, the data also shows that an increasing number of organisations have been successful in their security vulnerability management.

During 2010, 14% of all the assessments performed showed networks that were completely clear of security vulnerabilities. This figure increased to 25% of all assessments performed during 2011.

Repeat Technology Lifecycle Management Assessment clients fared even better – during 2010, 18% of all assessments showed no security vulnerabilities, a number that doubled to 37% for 2011.

In fact, repeat users of the TLM Assessment performed better than the general population with 59% of all devices carrying at least one known security vulnerability when compared to 75% for the entire sample set. This would seem to confirm that on going network visibility is a crucial component of successful vulnerability management.”

Dimension Data’s Conclusion of it report is below.

With the on going changes in the way IT services are consumed, in some cases driven by user demand, it has become more important than ever to take an architectural approach to network design. The adoption of enterprise mobility, virtualisation and cloud will place more pressure on an already stretched network and if it is not managed proactively will impact business agility, efficiency and ability to remain competitive.

Effective infrastructure management and network planning ensures that IT is able to meet the needs of the organisation at a tactical and strategic level, with additional benefits in terms of cost, asset optimisation and security. Dimension Data concludes that a technology lifecycle management (TLM) approach will address key architecture, security and configuration issues. We recommend this approach include six stages.

INITIATE: Determine the impact of the network technology lifecycle The first stage involves a business discussion about the network’s technology lifecycle, and the organisation’s existing and best fit longer term network architecture, considering risk, cost and strategic factors.

DISCOVER: Gather network data

Incorporates business and technical reviews with the key stakeholders to ensure the relevant information is collected. An asset list is required at this stage and if the organisation does not have an up to date list, a network scan will be required to create one. Dimension Data recommends a TLM Assessment to help identify lifecycle milestones as well as security and configuration issues.

CONSTRUCT: Perform gap analysis and develop recommendations

Here, the discovery data is analysed against security, configuration and end-of-life databases as well as checked for maintenance coverage status. There are automated tools to perform this task and the TLM Assessment service achieves this for Dimension Data clients. A technology roadmap will be created, based on the prioritised recommendations from the analysis. This will include configuration remediations as well as security and maintenance recommendations.

RECOMMEND: Consult and present the recommendations and roadmap

This consultative stage includes sharing the findings of the work done with key stakeholders and determining how to act on recommendations based on risk, cost and strategic factors. This will include a formal report and a collaborative discussion to develop an action plan.

EXECUTE: Execute on recommendations

IT operations will then execute on the recommendations. These may include allocating resources or working with a third party to address the security and network remediations that are required, reviewing maintenance and support contracts, and/or planning for equipment upgrades. As this is a multi-year planning approach, there are likely to be steps executed in future financial periods as the organisation’s needs dictate.

IMPROVE: Execute this discipline on an ongoing basis

Networks and markets are dynamic. Configurations will drift from best practice standards over time and additional products deployed will enter the manufacturer’s obsolescence lifecycle. In order to ensure the benefits of this approach over time, repeat assessments should be considered.

Like this:

A receptionist who unlawfully obtained her sister-in-law’s medical records in order to find out about the medication she was taking has been found guilty of an offence under section 55 of the Data Protection Act (DPA).

Usha Patwal, of Romford, was given a two year conditional discharge and ordered to pay £614 prosecution costs by Havering Magistrates Court after unlawfully obtained her sister-in-law’s medical records in order to find out about the medication she was taking.

The offence was uncovered when Patwal’s sister-in-law received text messages indicating that the texter knew about the medication she was taking.

The ICO investigation uncovered that Ms Patwal had made a call to Gateway posing as an employee of the King George Hospital in Romford, Essex, on 29 December 2010.

Further enquiries found that medical information had been faxed to Ms Patwal at the Lawns Medical Centre where she was employed as a receptionist. The fax has never been found and Mrs Patwal did not co-operate with the ICO investigation by giving an explanation for her actions.

“Medical records contain some of the most sensitive information possible. The medical centre’s receptionist was in a position of trust and abused her position for her own personal gain. This case demonstrates just how easy it can be to misuse personal data.

“Ms Patwal used her insider knowledge of the healthcare system to blag this information in an act that she believed would go undetected. The message from this case is clear: if you unlawfully obtain personal information there is always an audit trail, and you could end up in court.”